Alcohol Screening Tool

Screen QuestionsYesNo
Do you feel you are a normal drinker?    
Do friends or relatives think you are a normal drinker?    
Have you ever attended a meeting of Alcoholics Anonymous AA?    
Have you ever lost friends or girlfriends/boyfriends because of your drinking?    
Have you ever gotten into trouble at work because of drinking?    
Have you ever neglected your obligations, your family, or your work for two or more days in a row because you were drinking?    
Have you ever had delirium tremens DTs, severe shaking, after heavy drinking?    
Have you ever gone to anyone for help about your drinking?    
Have you ever been in a hospital because of your drinking?    
Have you ever been arrested for drunk driving or driving after drinking?    
Alcohol Screening Tool

Scoring:

  • 3 points or less = Nonalcoholic
  • 4 points = Suggestive of alcoholism
  • 5 or more = indicates alcoholism

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